Individual and community-level determinants of intention to use contraceptive among married women in Ethiopia: A multi-level analysis of National Survey

Abstract

AbstractBackgroundContraceptives are the most effective strategies to prevent unwanted pregnancies and their consequences. Realizing intention to use contraceptives is a crucial stage to draft and implement a successful family planning program.ObjectiveThis study aimed to identify individual and community level of factors affecting women’s intention to use contraceptives in Ethiopia.MethodThis study was based on a large national survey, Ethiopian Demographic and Health Survey. A total weighted sample of 6,555 married/in union reproductive-age women were included. Because of the hierarchical nature of the DHS data, a multilevel logistic regression model was used to study individual and community-level factors that may influence intention to contraceptive use. A 95% confidence interval and a p value of less than 0.05 were used to declare statistical significance.ResultThe overall intention to use contraceptives was 48.63% (95% CI 47.42, 49.84). Participants’ age range of 25-34 years (AOR = 0.42, 95 CI% (0.22, 0.79)) and 35-49 years (AOR = 0.12, 95% CI: (0.05, 0.28)), husband with primary education (AOR = 1.60, 95% CI: (1.02, 2.50)), heard of contraceptives from their community (AOR = 1.91. 95% CI: (1.29, 2.83)), ever used contraceptives (AOR = 4.48, 95% CI: (2.91, 6.88)) and having six or more children (AOR = 0.46, 95% CI: (0.23, 0.9)) were individual factors significantly associated with interceptive intention. From community level factors, high community family planning utilization rate (AOR = 2.29, 95% CI: (1.36,3.86)) was associated with intention to use contraceptive.ConclusionMore than half of married women were not intended to use contraceptives. Intention to use contraceptive was affected by individual and community level attributes. Thus, public health interventions particularly that could increase information dissemination regarding contraceptives among the communities and enhance community level contraceptive utilization rate are required at the national level to improve contraceptive utilization.